Confirmed metastasis to lung

Recently had a lung biopsy confirming metastasis to the lung. Bone scan is still clean. Oncologist says we should look at Zytiga as next step. The Z website says it is appropriate for metastatic hormone resistant. I am still getting a modest repsonse to the lupron but disease is progressing anyway. My impression is that Z is for metastasis to the bone. I can find very little regarding soft tissue. Any guidance on where to look or personal experience would be appreciated.

Don

Hi Jeff,
Provenge has come up but I am not a fan myself and I do not think my med onc is either. I have been thinking maybe a trial. From what I can gather speaking to some folks at Shands UF it is real rare to see lung mets before bone. Less than 10% of cases. They are thinking I may be able to radiate the nodules if there are less than 10. I do not know how many there are but I am mulling that over. I recently (last weekend) had a heart attack and my med onc says we would likely not do chemo either. Not sure what the connection is there.

Just looking for ideas and experiences. Thanks for your reply.

Don

Sorry to read of this, Don. Hope you can find an effective way to slow down things for you.

Soft tissue may be rare, as opposed to bones, but my oncologist, who only works with advanced PC and BC, says he sees cases of organ invasion vs. bones on a regular basis. Said it depends a lot on the variant on the PC itself, and some other factors.

David

Don, for what it is worth, a client/friend of mine had both a lung tumor and abdomonal lymph node tumor and never had any detectable bone involvement. The lung tumor was small cell PCa. Somewhat rare I understand.

don826 said...
Hi Jeff,
.... From what I can gather speaking to some folks at Shands UF it is real rare to see lung mets before bone. Less than 10% of cases. They are thinking I may be able to radiate the nodules if there are less than 10. I do not know how many there are but I am mulling that over. I recently (last weekend) had a heart attack and my med onc says we would likely not do chemo either. Not sure what the connection is there.

Just looking for ideas and experiences. Thanks for your reply.

Don

Don, do you go to Jacksonville or Gainesville?

I go to the latter monthly for Xgeva and 4very 16 weeks for Lupron. My medical oncologist is Dr. Bruce Stechmiller, and I also check in with director of admission Dr. Robert Zlotecki.

I have not yet met the guy who came in from Rochester and started the Metastatic Disease program, Dr. Paul Okunieff, but would if I ever qualify for any clinical trials that are hard to come by when still responding well to Lupron.

Hi don, sorry about your luck but here is the good news. When I was diagnosed my lungs looked like a leopard. Both of my lungs were covered with nodules. I have not had radiation. Lupron and casadex did the trick for a long time but when I became refractory the lung nodules began to come back as my Psa rose. I opted for Provenge and it gave me 14 progression free, side effect free months. I am now on Zytiga and my Psa has plummeted to less than one. Lung metastasis is still Prostate cancer. As your Psa drops so does the tumor bulk hence lowers Psa equals less tumor mass. It doesn't matter where the cancer is be it lungs bones lymph nodes bladder etc. my URL says patients with lung mets seem to do pretty good. Now a very prominate onco doc in Nevada told me to have my boys cut off but I opted to pass on that particular treatment. Zytiga works with lung mets. Provenge works with lung mets. Radiation kills a lot of healthy tissue as well. I am not ruling out radiation but at this point I am not ready to have my lungs shot full of holes. Read my blog if you have not done so already. 8 years of stage 4 Pca and I am doing well and living out loud. God willing, it will continue for a good long time. In the mean time work on what is sure to kill you quick. Get that old ticker in good shape. Best regards, todd

Good point Todd that it is still PCa not lung cancer or bone cancer just because the PCa has spread to the lung or to the bones.

LupronJim

Hi Todd,
I have followed your case since your first posting and recall quite clearly that you had lung mets at diagnosis. I also recall that you had a very good response to the lupron that cleared them up at the time. I have had the same advice about my two best friends. Not ready for that yet.

SL,
I have read that as well. So far there has been no indication other than one morning of coughing up blood. That led me to get x-ray of lung that showed nodules and that led to biopsy which says PCa. Odd thing is the cough went away immediately and has not returned. I am fairly active and do intervals on my exercise bike and have no problem breathing. Doctor says lungs are clear when he listens to them.

Gunner,
I think chemo may still be available but I need to speak to me cadiologist to see if any damage was done. I was just showing symptoms of heart issue and they placed two stents. I could have walked out of the hospital when they took me off the bed as far as how I felt. I really do not want to do the chemo as it is lengthy and somewhat debillatating treatment and not a lot of OAS benefit. I feel quite well and can do most of what I want to do so I am just coasting at the moment.

Thanks for comments and advice. As always here it is given with compassion and thoughtfulness.

Don